Pituitary apoplexy after leuprolide

被引:19
作者
Davis A. [1 ]
Goel S. [1 ]
Picolos M. [1 ]
Wang M. [1 ]
Lavis V. [1 ]
机构
[1] University of Texas Health Science Center - Houston, Houston, TX 77030
关键词
Adenoma; Pituitary Adenoma; Goserelin; Leuprolide; Pituitary Apoplexy;
D O I
10.1007/s11102-006-8616-6
中图分类号
学科分类号
摘要
Clinically unsuspected pituitary adenomas are common among adults on autopsy and MRI survey. Acute pituitary hemorrhage is far more rare. We report a case of a 61-year-old male patient with locally advanced prostate cancer who presented with an acute picture of pituitary apoplexy after his first dose of leuprolide. He developed headache and neck pain within a few hours of treatment followed by nausea, vomiting, ptosis and diplopia. Pituitary apoplexy is a potentially life threatening medical emergency. Although the pathophysiology is poorly defined, various conditions and treatments have been reported to trigger apoplexy. Apoplexy has been reported in response to pituitary stimulation by GnRH or GnRH-agonists. Initial stimulatory effects of gonadotropin releasing hormone (GnRH) analogue may induce apoplexy in patients with asymptomatic gonadotroph adenomas. © Springer Science + Business Media, LLC 2006.
引用
收藏
页码:263 / 265
页数:2
相关论文
共 13 条
[1]  
Teramoto A., Hirawaka K., Sanno N., Osamura Y., Incidental pituitary lesions in 1000 unselected autopsy specimens, Radiology, 93, pp. 16-24, (1994)
[2]  
Chong B.W., Kucharczyk W., Singer W., George S., Pituitary gland MR: A comparative study of healthy volunteers and patients with microadenomas, Am J Neuroradiol, 15, pp. 675-679, (1994)
[3]  
Cardoso E.R., Peterson E.W., Pituitary apoplexy: A review, Neurosurgery, 14, pp. 363-373, (1984)
[4]  
Randeva H.S., Schoebel J., Byrne J., Esiri M., Adams C.B.T., Wass J.A.H., Classical pituitary apoplexy: Clinical features, management and outcome, Clin Endocrinol, 51, pp. 181-188, (1999)
[5]  
Biousse V., Newman N.J., Oyesiku N.M., Precipitating factors in pituitary apoplexy, J Neurol Neurosurg Psychiatry, 71, pp. 542-545, (2001)
[6]  
Conn P.M., Crowley W.F., Gonadotropin-releasing hormone and its analogues, N England J Med, 324, pp. 93-103, (1991)
[7]  
Ando S., Hoshino T., Mihara S., Pituitary apoplexy after goserelin, Lancet, 345, (1995)
[8]  
Eaton H.J., Phillips P.J., Hanieh A., Cooper J., Bolt J., Torpy D.J., Rapid onset of pituitary apoplexy after goserelin implant for prostate cancer: Need for heightened awareness, Intern Med J, 31, pp. 313-314, (2001)
[9]  
Thompson I.M., Zeidman E.J., Rodriguez F.R., Sudden death due to disease flare with luteinizing hormone-releasing hormone agonist therapy for carcinoma of the prostate, J Urol, 144, pp. 1479-1480, (2001)
[10]  
Chanson P., Schaison G., Pituitary apoplexy caused by GnRH-agonist treatment revealing gonadotroph adenoma, J Clin Endocrinol Metab, 80, pp. 2267-2268, (1995)